Int.J.Curr.Microbiol.App.Sci (2014) 3(1): 453-458
ISSN: 2319-7706 Volume 3 Number 1 (2014) pp. 453-458
http://www.ijcmas.com
Original Research Article
Rapid Diagnosis of Rota-Adenoviruses for Acute Gastroenteritis in
hospitalized Children under 4 Years Old, Baghdad
Razaq Hadi Eissa Al-Sayidi1, Hula Y.Fadhil2*, Faisal G.AL- Hamdani1
1
Departmentof Virology, The National Central Public Health Laboratory (NPL), Ministry of
Health, Baghdad-Al-Andlus Street, Iraq
2
Department of Biology, College of Science, University of Baghdad, Baghdad-Al-Jadiria, Iraq
*Corresponding author
ABSTRACT
Keywords
Rotavirus;
Enteric
Adenovirus;
Gastroenteritis;
Immunochromotography
and Iraqi
children.
Rotavirus and adenovirus are respectively the first and second most common
agents responsible for acute gastroenteritis, mainly in young children. In Iraq, little
data arerecorded about these viral infections other than Baghdad province, so we
designed this study to investigate the prevalence frequencies of both viruses and
their role in viral diarrheal.Out of 450 diarrhea cases, 150 stools sampled have
negative tests for parasites and bacterial infections were targeted in this study.
Frequency of rotavirus and adenovirus were observed in 25.5% of all children with
acute gastroenteritis, while the distribution of positive cases for rotavirus was
91.3%, 2.6% for adenovirus and 6.09% for rota-adenoviruses among studied
groups.Significant frequency showed in children less than 2 years of each rota and
rota-adenoviruses, whereas the adenovirus in children with 3-4 years.The highest
prevalence of rotavirus among viral pathogens in children with diarrhea, we
recommended more studies are necessary in order to evaluate the vaccine
efficiency. Moreover, these findings established the evidence that adenovirus play a
major role in coinfection with rotavirus and severity of diarrhea among children
especially less than 3 years old.
Introduction
Acute gastroenteritis is one of the most
common diseases in humans worldwide.
Viral gastroenteritis is a global problem in
infants and young children (Magalhaes et
al., 2007). Diarrhea remains the second
leading cause of death around the world
for children under 5 years of age (Black et
al., 2010). In the developing world
rotavirus may account for 1 million
childhood deaths as well as significant
morbidity each year (Kane et al., 2004).
Rotavirus from group A is the more
prevalent cause of viral gastroenteritis and
can be detected by a variety of techniques
including latex agglutination (LA) and
enzyme immunoassay (EIA).The enteric
serotypes that are most frequently
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Int.J.Curr.Microbiol.App.Sci (2014) 3(1): 453-458
associated with gastroenteritis caused by
adenovirus are 40 and 41, which belong to
subgenus A and serotypes 1, 2,5, and 6 of
subgenus C have been involved in the
etiology of acute diarrhea (Baum
2000).Adenoviruses are second only to
rotavirus as the most important causative
agents of acute infantile gastroenteritis
(Zlateva et al., 2005).
Out of 450 diarrhea cases, 150 stools
sampled have negative tests for parasites
and bacterial infections were targeted in
this study. The clinical history, sociodemographic characteristics, physical
examination and laboratory tests were
recorded. Stool samples were collected
between Januarys to March 2013and
stored at -20c tile use.
The main symptoms of rotavirus
gastroenteritis
(RVGE)
are
fever;
abdominal pain, lethargy; diarrhea and
vomiting that may lead to hypovolemic
shock and dehydration. Severe cases may
lead to death. The World Health
Organization (WHO) estimates that
527,000 children under the age of five
years die of rotavirus disease each year.
Children in the poorest countries account
for 82% of rotavirus deaths (Khoury et al.,
2011).The fact that enteric adenoviruses
produced symptoms that were milder than
symptoms in patients with rotavirus
infection may have resulted in underreporting (Hamkar et al., 2010).
In Iraq, the death rate in children <5 years
of age was reported to be 130/1,000 for
boys and 120/1,000 for girls in 2003
(World Health Organization, 2003).
Diarrhea is a major cause of illness and
death in Iraqi children. Furthermore, little
data is recorded about these viral
infections other than Baghdad province, so
we designed this study to investigate the
prevalence frequencies of both viruses and
their role in viral diarrheal.
Identification of Rota and Adenoviruses
Materials and Methods
Results and Discussion
Stool Sample
Our finding observed that the frequency of
rotavirus and adenovirus were 25.5% of all
children with acute gastroenteritis, while it
represented as 76.7% of children who had
negative testing for bacteria and parasites
(Table 1). On the other hand, the
Immuno-chromatography test (ICT) was
used for rotavirus and adenovirus antigen
detection.Further, all selected samples
were analyzed for group A rotavirus using
latex (Barcelona-Spain) and ELISA
(ProSpectTMOxoid
Ltd,
UK)
asa
confirmatory
test.
VIKIA
rotaadenoviruses (bioMerieux, France) are a
rapid test for the qualitative dual detection
of rotavirusand adenovirus in human stool.
This test uses immunological reactions
performed on a test strip by migration
(ICT or lateral flow format) according to
manufacture's instructions.
Statistical Analysis
The data and graphs were carried out using
spss program version 20 IBM. The
proportion and their frequencies were
checked by applying chi-square test to
estimate the relative risk of rotaadenoviruses to diarrheal infection. The Pvalues < 0.05 considered statistically
significant.
A total of four hundred and fifty
hospitalized children under 4-years, who
suffering from acute gastroenteritis were
tested for common bacteria and parasites.
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Int.J.Curr.Microbiol.App.Sci (2014) 3(1): 453-458
distribution of positive cases for rotavirus
was 91.3%, 2.6% for adenovirus and
6.09% for rota-adenoviruses among
studied groups. A significant incidence of
study viral infections among diarrhea
cases in children were appeared
(P<0.001).
frequencies among diarrhea cases between
14.9% and 56% (Hussien and Hassan,
2000; Ahmed et al., 2006; Al-Marzoqi et
al., 2011; Zaman et al., 2012; Al-Khafaj
and Al-Jiboury, 2013).
Not many studies on adenovirus detection
in children with diarrhea have been carried
out. Thus, our findings indicated that the
adenovirus prevalence of 2.23% in
children with acute gastroenteritis as
causal or coinfection with rotavirus. This
observation differs from both Iraqi studies
that reported 6.6% and 20% of children
with acute gastroenteritis as enteric
adenovirusinfection in Babylon and
Kirkuk provinces, there is no reported
coinfection with rotaviruses (Al-Marzoqi
et al., 2011; Zaman et al., 2012), but it was
agreed with other previous studies in
developing countries such as in Iran,
China, Singapore and Indonesia showed
that enteric adenovirus was found in 2.3%,
2.5%, 3% and 4% of diarrheal patients
respectively (Hamkar et al., 2010; Subekti
et al., 2002; Qiao et al., 1999;Mendis et
al., 1995).
According to the age groups, the highest
frequency showed in children less than 2
years of each rota and rota-adenoviruses,
whereas the adenovirus in children with 34 years. The significant rotavirus infection
was shown in all age groups (P<0.05).
Moreover, the highest significant rota and
rota-adenoviruses infection were noticed
in children with less than 2 years
(P<0.001) (Fig. 1). Regarding the
adenovirus infection was showing
significant in children with 3-4 years
(P<0.001). In the current study, we
reported that male children more exposure
to viral infection than female and there is
significant differences between them
(P<0.05).
Figure 2 demonstrates that infected
children with rota-adenovirus more sever
of clinical signs than single infection with
these viruses, although there are no
significant differences between the
severity of symptoms and the type of viral
infection (P=0.06).
As mentioned above, rotavirus and
adenovirus were caused 91.1% and 6.8%
of viral pathogens in selected children
with diarrhea, respectively. These
prevalences are different from those
detected in our population. In the current
study, immunochromtochraphy test was
established that higher (100%) sensitivity
and specificity by detecting of rotavirus
with latex and ELISA assays.
In several international reports, it was
evident that viral pathogens are the most
common cause of gastroenteritis in
developing countries Worldwide (Merteus
et al., 1990; Mclver et al., 2001; Simpson
et al., 2007).Ourstudyshowed a rotavirus
prevalence of 24.89% in children with
diarrhea. Similar value was obtained
previous study in Rondonia (Magalhes et
al., 2007), this comparsion may be due to
studied sample size.Meanwhile, several
Iraqi investigators listed the rotavirus
This finding indicated that 23.3% was
absent for common bacteria, parasites and
viruses causes diarrhea. This percent may
be explained many causes like other
viruses, medications (such as antibiotics),
lactose
intolerance
and
artificial
sweeteners.
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Int.J.Curr.Microbiol.App.Sci (2014) 3(1): 453-458
Table.1 Distribution of positive cases and their frequency for Rota and Adenoviruses among
children with diarrheal infection
Viral pathogen
(no. of positive)
Frequency among diarrhea cases
Only negative cases
Only Positive cases for
for bacteria and
Rota and Adenovirus,
parasites, n=150
n=115
Total
diarrhea
cases,
n=450
23.33%
0.67%
1.56%
Rotavirus (105)
Adenovirus (3)
Rota-Adenovirus
(7)
Total (115)
25.56%
70%
2%
4.7%
91.3%
2.61%
6.09%
76.7%
100%
Fig.1 Proportion of viral infection by age groups among 150 children suffering of
gastroenteritis after testing for bacteria and parasites, between Januarys to March 2013. The
asterisk indicates that the differences are significant. * P<0.05; **P<0.001.
No. of Positive cases
**
47.82%
* 28.7%
* 14.78%
* 4.35%
1.74%
0
0
*
0 2.61%
Year
Year
Year
Viral Pathogen
Frequency mean of
symptoms
Fig.2 Observation of clinical symptoms according to viral infection among study group, no
significant differences between the severity of symptoms and the type of viral infection
(P=0.06).
Diarrhea
Vomiting
Viral Pathogen
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Int.J.Curr.Microbiol.App.Sci (2014) 3(1): 453-458
Generally, rotavirus diarrhea is more likely
to be associated with fever, vomiting, and
dehydration than diarrhea caused by other
pathogens (Seo and Sim, 2000). In our
study, fever, vomiting, and dehydration
were observed at severity in the children
infected with rota-adenoviruses. These
symptoms did not differ significantly from
those with single viral infection in children,
indicating the role of adenovirus as
coinfection in diarrheal disease in Iraqi
children. Furthermore, the coinfections
could cause difficulties for pediatricians and
health care workers in terms of the
diagnosis, treatment, and prophylaxis of
diarrhea in children (Vu Nguyen et al.,
2004).
play a major role in coinfection with
rotavirus and severity of diarrhea among
children especially less than 3 years old.
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